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Does online therapy work?

Credit: Kate Walker

It’s a new year, and it’s time to head back to uni! Except, you can’t seem to motivate yourself to get out of bed no matter how hard you try. Or perhaps the thought of going to class fills you with dread and makes your stomach churn. If so, you’re not alone. 1 in 4 uni students will experience a mental health issue in any given year, while the average millennial spends almost 12 hours per day in front of a screen. With this in mind, it’s a no-brainer that technology presents a powerful opportunity to improve young people’s mental health. However, there are so many websites, forums and apps out there that it can be hard to know where to start. How do you know if they actually work? Which ones should you use? And how do you know when they’re not enough, and it’s time to seek some extra help? After spending a semester conducting a literature review on this topic as part of my science degree, here’s what I found: 

Do they work? 

The short answer is yes! Researchers have found that online tools are often just as effective at treating anxiety and depression as visiting a psychologist. Studies have consistently demonstrated that approximately 50-70% of people who use technology-based treatments will achieve symptom remission in as little as 12 weeks, with these effects being maintained when researchers follow up with participants months later. There are a few caveats to this finding though. Firstly, it’s important that you actually use the app or the website regularly, and make sure you practice the strategies it’s teaching you in real life. After all, practice makes perfect! It can also often be harder to motivate yourself when there’s not a mental health professional there to encourage you. Secondly, studies will often exclude people with severe mental health issues due to ethical concerns. So, if you’re constantly anxious or severely depressed, it’s unclear whether technology on its own will be enough to properly help you. 

Some benefits of online interventions: 

  • Cost-effective – often free! 
  • Often anonymous, so nobody needs to know that you’re accessing support 
  • Can be accessed wherever and whenever you like

Some drawbacks of online interventions: 

  • Can be hard to get tailored support to your issues 
  • May rely on an internet connection 
  • Can feel ‘robotic’ – some people prefer the human connection that comes with talking to a person 
  • Require users to be highly self-motivated (which can be difficult when suffering from depression) 
  • Not always suitable on their own for people with significant mental health issues

Which ones should you use? 

There’s inconsistent evidence to suggest that any one type of tool is more effective than others. It seems that a more important factor is how regularly you use the tool. It therefore comes down to individual preference – if you like the look and feel of a tool, you’re more likely to use it. When choosing between apps or websites, it can be helpful to know that there has been research testing their effectiveness. ReachOut Australia has a page which gives an overview of different mental health apps, including reviews from qualified mental health professionals (https://au.reachout.com/tools-and-apps). There’s also Beacon, which reviews the quality of evidence behind interventions for approximately 40 different physical and mental health concerns (https://beacon.anu.edu.au/categories). 

Seeking extra help/What resources are out there: 

Despite your best efforts, you may find that an app or a website isn’t enough to help you through a tough time. Or perhaps you’re already seeing a professional for mental health issues, but are wanting to get the most out of your sessions. The great news is that you can combine online and face-to-face supports! Technology can often help you to practice strategies in between sessions. The following list, while not exhaustive, provides an overview of tools which use many of the same evidence-based strategies as psychologists: 

FORUMS: 

ReachOut Australia (14-25 year olds) 

ReachOut Forums is a supportive, safe and anonymous space where people care about what’s happening to you, because they’ve been there too. 

BeyondBlue 

Whatever it may be, sharing the load with someone else can really help. So no matter who you are, or how you’re feeling, you can talk it through with us – we’ll point you in the right direction so you can seek further support. 

SANE Australia 

Safe, anonymous mental health discussion, moderated 24/7 by mental health professionals.

PHONE APPS: 

Mood Mission (Free on iOS and Android) 

MoodMission helps you learn new and better ways of coping with low moods and anxiety. Tell MoodMission how you’re feeling and it will give you a tailored list of five Missions that can help you feel better. Missions are activities and mental health strategies that are quick, easily achievable, and backed up by scientific evidence. 

Pacifica (Free on iOS and Android) 

Stress, anxiety, and depression can get in the way of you living your life. Pacifica gives you psychologist-designed tools to address them based on cognitive behavioural therapy, mindfulness meditation, relaxation, and mood/health tracking. 

Headspace (Free on iOS and Android) 

Headspace is meditation made simple. The app takes you through the basics of meditation, with progress pages to track your stats and reminders to help you with your practice. 

Calm Halm (Free on iOS and Android) 

Calm Harm provides tasks that help you resist or manage the urge to self-harm. You can add your own tasks too and it’s completely private and password protected. 

As you can see, there are many options out there, meaning that there’s sure to be one which suits your needs! Remember that you’re not alone in your struggles and that there are many different ways you can seek help. Research in this area is ongoing (including here at Monash!) so treatments will continue to get even better over time. 

Credit: Kate Walker
Clare Amos

The author Clare Amos

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